Stacy Nicole Coleman
Individual provider Active NPI Early Intervention Provider Agency · Scott Depot, WV
NPI 1497616668 · NPPES record last updated Nov 18, 2025
Key facts
- NPI
- 1497616668
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Early Intervention Provider Agency 252Y00000X
- Practice address
- 7 Meadow Wood Estates
Scott Depot, WV 25560 - Phone
- (304) 415-0590
- NPI assigned
- Nov 18, 2025
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Early Intervention Provider Agency | 252Y00000X | WV | Yes |
Addresses
Primary practice location
7 Meadow Wood Estates
Scott Depot, WV 25560
Mailing address
7 Meadow Wood Estates
Scott Depot, WV 25560
Phone (304) 415-0590
Other providers in Scott Depot, WV
- Matthew Childress
- Christopher C Skaggs
- Ryan R Cicenas
- Kara A. Cipriani
- Nicole Danielle Clendenin
- William Robert Coles
- Danielle Collins
- Communication Station, Inc.
- Hannah Aspy Conley
- Kevin Cool
All providers in Scott Depot, WV · Early Intervention Provider Agency in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 18, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.